Cleanliness monitoring method and system

ABSTRACT

The present invention relates to a cleanliness monitoring method for enhancing hygiene in a room or area of a facility, especially a hospital. After cleaning, the level of cleanliness is verified via real time biological and/or microbiological measurements using a hand held device such as an ATP luminometer. Until the desired level of cleanliness has been achieved, cleaning is repeated. Motion sensors determine the activity level of a room (such as a bathroom) and communicate enhanced cleaning needs centrally or to the hand-held device. The hand-held device can be a smartphone or tablet provided with an add-on module.

FIELD OF THE INVENTION

The present invention relates to a hygiene enhancing method forenhancing hygiene in a room or area of a facility and to a hygieneenhancing system for carrying out the hygiene enhancing method.Furthermore, the invention relates to a facility or building comprisingthe hygiene enhancing system and to the use of the hygiene enhancingsystem.

BACKGROUND ART

Many people consider cleaning an insignificant low status job with nodevelopment opportunities. Most people are taught how to clean by theirparents, and people usually do it in their own homes. A trivial jobwhich most people want to get done as quickly as possible.

This attitude is actually a very good indication of the focus we want toput on cleaning. Similarly, the daily handling of cleaning procedures ine.g. hospitals is deprioritised in favour of treatment, care andresearch.

Surveys show that 10 percent of all hospitalised patients acquire aninfection due to inadequate hygiene. Hospital-acquired infections cause3,000 Danes dying every year as well as more than 1 million sick days,just as inadequate hygiene places an economic burden on society of closeto DKK 4 billion. WHO (World Health Organization) estimates that inEurope alone, hospital-acquired infections result in a total of 16million extra hospital days, 37,000 deaths and cost approximately EUR 7billion (WHO).

Efforts within the area of cleaning are in far most cases aimed atreducing the costs of the actual cleaning and at minimising theenvironmental impact of cleaning, and no one has yet been able to comeup with technological solutions which create the necessary overview ofthe effort and quality of cleaning. Similarly, no one has appliedtechnology in an effort to support the daily work of cleaning staff andto ensure that their work is continuously done so professionally that aspread of infectious deceases can be reduced.

Studies of the cleaning efforts made in Danish hospitals show that it isnot possible to assess the value of the general cleaning effort inDenmark because the quality of the work done cannot be surveyed. This isproblematic for several reasons, e.g.:

-   1) If the quality of the work you pay for cannot be surveyed, it is    not possible to establish and maintain a serious national quality    level of the cleaning effort.-   2) If a target quality level cannot be established, it is not    possible to make demands on an internal organization or external    suppliers regarding their work.-   3) If it is not possible to make demands on the cleaning you pay for    on very specific and documented grounds, a desire to improve the    effort will be aimless. A simple conclusion is that it is currently    not possible to link the cleaning effort and the effect of same.

At present, no legislation dealing with this problem exists, which ispresumably a consequence of the fact that no system exists for measuringand assessing the level of hygiene. Presently, conventional cleaning andcontrol thereof is carried out on the basis of DS/INSTA 800 which isbased on an assessment of visual cleanliness and not hygieniccleanliness. Consequently, the cleaning effort is generally not directedtowards the non-visible illness-inducing microorganisms.

In other words, demands are made as to how clean a place must appear,but only limited demands are made in terms of assessing whether theplace is biologically/microbiologically clean.

SUMMARY OF THE INVENTION

It is an object of the present invention to wholly or partly overcomethe above disadvantages and drawbacks of the prior art. Morespecifically, it is an object to provide a hygiene enhancing method andsystem which enables a higher degree of cleanliness than the prior art.

It is also an object to provide a method and system in which a personresponsible for the hygiene of a facility may determine a hygiene levelthrough continuous real-time cleaning and behaviour measurements.

The above objects, together with numerous other objects, advantages, andfeatures, which will become evident from the below description, areaccomplished by a solution in accordance with the present invention by ahygiene enhancing method for enhancing a hygiene in a room or area of afacility, the method comprising the steps of:

-   cleaning the room or area,-   extracting one or more samples from predetermined surfaces in the    room or area,-   performing real-time measurements of a biological and/or    microbiological level of cleanliness of the one or more samples by    means of a on-site hand-held device,-   comparing the measured level of cleanliness of the one or more    samples with a predetermined biological and/or microbiological    threshold for acceptable hygiene,-   determining if the measured level of cleanliness is lower than the    predetermined threshold,-   cleaning the room or zones of the room having a lower level of    cleanliness than the predetermined threshold,-   extracting one or more samples from the predetermined surfaces in    the room or area having the lower level of cleanliness than the    predetermined threshold,-   performing real-time measurements of the level of cleanliness of the    one or more samples extracted from the predetermined surfaces in the    room or area having the lower level of cleanliness than the    predetermined threshold by means of the on-site hand-held device,-   comparing the predetermined threshold with the measured level of    cleanliness of the one or more samples from the predetermined    surfaces in the room or area having the lower level of cleanliness    than the predetermined threshold,-   determining if the measured level of cleanliness is lower than the    predetermined threshold, and-   continuing the steps of cleaning, extracting samples, measuring    samples, comparing and determining until the real-time measured    level of cleanliness for all predetermined surfaces is below the    predetermined threshold.

The hygiene enhancing method may further comprise the step ofcommunicating the level of cleanliness measured in real-time to acentral control unit in order to collect data of the hygiene of the roomor area being cleaned and/or of a cleaning operative cleaning the roomor area to be used for enhancing the competences of the cleaningoperative.

Moreover, the hygiene enhancing method may further comprise the steps ofproviding a position of the hand-held device by means of a positioningunit in the hand-held device, and communicating the real-time positionof the hand-held device to the central control unit.

Furthermore, the hygiene enhancing method may comprise the steps ofmonitoring an activity load of the room or area by means of sensorsarranged in the room or area, and communicating the activity load to thecentral control unit.

In addition, the hygiene enhancing method may comprise the step ofarranging for cleaning of a room or area on the basis of the activityload of the specific room or area.

Further, the hygiene enhancing method may comprise the step ofcommunicating to the hand-held device when the hand-held device enters aroom or area having a high activity load to warn the cleaning operativescleaning the room or area that additional cleaning of the room or areamay be needed in order for the level of cleanliness measured inreal-time to be lower than the predetermined threshold.

In an embodiment, the step of comparing may be performed automaticallyby the hand-held device.

The hygiene enhancing method may further comprise the step ofcommunicating additional and/or strict cleaning procedures andguidelines to the hand-held device when the hand-held device enters aroom or area having special cleaning needs, such as an outbreak of E.Coli or Clostridium Difficile.

Additionally, the hygiene enhancing method may comprise the step ofproviding cleaning procedures and guidelines on a display of thehand-held device to give the cleaning operative cleaning the room orarea real-time access to the procedures and guidelines.

In an embodiment, the step of extracting samples may be performed by thecleaning operative touching each of the predetermined surfaces with aseparate testing item, and the step of measuring the level ofcleanliness may be performed by inserting each of the samples into thehand-held device or an add-on module connected to the hand-held device.

The hygiene enhancing method may further comprise the step of performingreal-time monitoring of the consumption of cleaning detergents and/orcleaning articles.

Moreover, the hygiene enhancing method may comprise the step ofperforming real-time monitoring of the type of cleaning detergents beingused.

The present invention furthermore relates to a hygiene enhancing systemfor carrying out the hygiene enhancing method according to any of thepreceding claims, the hygiene enhancing system comprising:

-   a transport unit with cleaning detergents and cleaning articles to    be used for cleaning a room or area of the facility,-   a plurality of testing items for extracting one or more samples from    predetermined surfaces, and-   an on-site hand-held device for performing real-time measurements of    a biological and/or microbiological level of cleanliness of the one    or more samples.

In an embodiment, the hand-held device may comprise a communication unitadapted to send and receive information.

Furthermore, the hand-held device may be a smartphone or a tablet.

In addition, an add-on module may be connected to the hand-held device,the add-on module being adapted to measure the level of cleanliness ofthe one or more samples.

Moreover, the hand-held device may comprise a camera and a processor,the camera and processor being adapted to function as a biosensor fordetecting the biological and/or microbiological level of cleanliness ofthe samples.

Also, the hand-held device together with the add-on module may beadapted to function as an ATP meter or a CFU meter.

The hygiene enhancing system may further comprise a central control unitconnected with the hand-held device and/or the transport unit.

In an embodiment, the level of cleanliness measured in real-time may becommunicated to the central control unit in order to collect data of thehygiene of the room or area being cleaned and/or of a cleaning operativecleaning the room or area to be used for enhancing competences of thecleaning operative.

Moreover, the hand-held device may comprise a positioning unit, and thepositioning unit may communicate the real-time position of the hand-helddevice to the central control unit.

Furthermore, the positioning unit may be a global positioning system(GPS) of the hand-held device.

In addition, the positioning unit may be based on WIFI-positioning ofthe hand-held device.

The positioning unit may also be based on RFID positioning.

Additionally, the positioning unit may be based on ZigBee positioning.

Additionally, the transport unit may comprise a positioning unit.

Also, the hand-held device may comprise a display.

Further, one or more sensors may be arranged in the room or area tomonitor the activity load of the room or area and/or the consumption ofsoap dispensers, paper dispensers or disinfectant dispensers arranged inthe room or area.

In addition, the one or more sensors may be connected with the centralcontrol unit.

Moreover, the central control unit may comprise a storage unit forstoring data and observations received from the hand-held device, thetransport unit and/or the sensors.

Furthermore, the control unit may send a message to the hand-held devicewhen the hand-held device enters a room or area having a high activityload in order to warn the cleaning operatives cleaning the room or areathat additional cleaning of the room or area may be needed in order forthe level of cleanliness measured in real-time to be lower than thepredetermined threshold.

Additionally, the central control unit may communicate additionalcleaning procedures to the hand-held device when the hand-held deviceenters a room or area having special cleaning needs, such as an outbreakof E. Coli or Clostridium Difficile.

Also, the hand-held device may comprise cleaning procedures andguidelines accessible for the cleaning operative cleaning the room orarea.

Moreover, the cleaning detergents may comprise flow meters/sensors,whereby the consumption of cleaning detergents is monitored.

Moreover, the cleaning detergents may comprise an RFID chip, whereby thepresence of the specific cleaning detergents can be monitored.

Further, the predetermined surfaces may be the surfaces in the room orarea which are most frequently touched by persons present in the room orarea.

In addition, the transport unit may comprise a docking station or cradlefor the hand-held device.

Furthermore, the transport unit may comprise a power supply for thehand-held device.

The present invention furthermore relates to a facility or buildingcomprising the hygiene enhancing system as described above.

Finally, the present invention relates to the use of the hygieneenhancing system as described above for hospitals, day care centres,schools, institutions, public buildings, pharmaceutical companies, foodindustry, restaurants, offices, etc.

BRIEF DESCRIPTION OF THE DRAWINGS

The invention and its many advantages will be described in more detailbelow with reference to the accompanying schematic drawings, which forthe purpose of illustration show some non-limiting embodiments and inwhich

FIG. 1 shows a flow-chart of a procedure for hygiene enhancement duringcleaning according to the present invention,

FIG. 2 shows the transport unit of the hygiene enhancing system,

FIG. 3 shows one embodiment of the hygiene enhancing system,

FIG. 4 schematically shows different zones of a hospital,

FIG. 5 schematically shows the hand-held device and a sample beinginserted into an add-on module,

FIG. 6 schematically shows how the hygiene enhancing system assists acleaning operative,

FIG. 7 shows a lavatory of a hospital seen from the end of the lavatoryroom opposite the door,

FIG. 8 shows the lavatory of FIG. 7 in another view, and

FIG. 9 schematically shows a hygiene behaviour support system motivatingpersons to enhance their hand hygiene after lavatory visits.

All the figures are highly schematic and not necessarily to scale, andthey show only those parts which are necessary in order to elucidate theinvention, other parts being omitted or merely suggested.

DETAILED DESCRIPTION OF THE INVENTION

FIG. 1 shows a flow chart of a cleaning procedure according to thepresent invention. In the first step 100, a room or an area is cleaned.When the cleaning has been completed, the second step 101 is performed,in which one or more samples from predetermined surfaces in the room orarea is/are extracted. In the third step 102, a biological and/ormicrobiological level of the cleanliness of the one or more samples ismeasured in real-time by means of an on-site hand-held device. In thefourth step 103, the measured level of cleanliness of the one or moresamples is compared with a predetermined biological and/ormicrobiological threshold for acceptable hygiene. As can be seen in thefifth step 104, if the measured level of cleanliness is lower than thepredetermined threshold, the cleaning operative is sent back to thefirst step 100 to clean the room or area more thoroughly. The steps100-104 are repeated until the measured level of cleanliness of allpredetermined surfaces are below the predetermined threshold, and then,the cleaning operative continues to the next room or area to be cleaned,as shown in step 105. Hereby, it is possible for the cleaning operativesto carry out their cleaning assignments with a high degree ofprofessionalism, and hygiene efforts may be continuously documented inreal-time and adjusted by means of the hand-held devices available forthe cleaning operatives on-site. Since the cleaning operatives check thebiological and/or microbiological level of cleanliness in real-time andensure that it is kept below the predetermined threshold of acceptablecleanliness of the actual room or area, the overall hygiene level of theroom or area is enhanced considerably.

FIG. 2 shows a transport unit 110 of the hygiene enhancing system. Thetransport unit 110 comprises cleaning detergents 111 and cleaningarticles 112 to be used for cleaning a room or area of a facility. Inthis embodiment, the transport unit 110 also supports an on-sitehand-held device 113 for performing real-time measurements of abiological and/or microbiological level of cleanliness of the one ormore samples (not shown). The transport unit may also have a pluralityof testing items (not shown) for extracting one or more samples frompredetermined surfaces in the room or area. The predetermined surfacesare the surfaces in the room and/or surfaces on equipment or componentsbeing present in the room or area which are most frequently touched bypersons present in the room or area. The predetermined surfaces may e.g.be surfaces of equipment, beds, tables, toilet seats, sinks, doorhandles, walls, etc.

The transport unit 110 functions as a wagon having wheels 114 enablingit to be moved around in the facility to be cleaned. The transport unit110 may be pushed by the cleaning operative 115 or it may beself-propelled.

In this embodiment, the hand-held device 113 is a known tablet having atouch display 116. Furthermore, an add-on module 117 is connected to thetablet, the add-on module 117 being adapted to measure the level ofcleanliness of the one or more samples. The tablet 113 comprises acamera (not shown) and a processor, and the camera and processor areadapted to function as a biosensor for detecting the biological and/ormicrobiological level of cleanliness of the samples, and the tablet 113together with the add-on module 117 are adapted to function as an ATPmeter or a CFU meter. In other embodiments, the hand-held device may bea smartphone.

An ATP test is a process of rapidly measuring actively growingmicroorganisms through detection of adenosine triphosphate (ATP). ATP isa molecule found only in and around living cells, and as such, it givesa direct measure of biological concentration and health. ATP isquantified by measuring the light produced through its reaction with thenaturally-occurring firefly enzyme Luciferase using a Luminometer. Theamount of light produced is directly proportional to the amount ofbiological energy present in the sample. Thus using the tablet orsmartphone with the add-on module 117 enables the cleaning operative toperform real-time measurements of the predetermined surfaces to evaluatethe level of cleanliness.

Furthermore, the hand-held device 113 comprises a communication unitadapted to send and receive information. The communication unit may be a3G/4G modem, or it may be the Bluetooth capability built into mosttablets and smartphones commercially available today.

In addition, the hand-held device 113 may also comprise a positioningunit communicating the real-time position of the hand-held device toe.g. a central control unit for the entire hygiene enhancing system. Thepositioning unit may be a global positioning system (GPS) of thehand-held device, or again, the 3G/4G modem or Bluetooth capability ofthe hand-held devices may be used to establish the position of thehand-held device. In another embodiment, the transport unit 110 maycomprise a positioning unit.

Moreover, the transport unit 110 may comprise a docking station orcradle for the hand-held device 113, and the transport unit 110 may alsocomprise a power supply for the hand-held device.

FIG. 3 shows an embodiment of the schematic overall structure of thehygiene enhancing system 120. The hygiene enhancing system 120 may beused in one or more facilities or buildings 121. In the presentembodiment, the facilities are three hospitals; A, B, and C. Eachhospital comprises different rooms and areas to be cleaned, which willbe described further below.

The hygiene enhancing system 120 comprises a central control unit 122connected with at least the hand-held device 113 and/or the transportunit. The central control unit 122 is wirelessly connected with thedifferent components, units, such as sensors 130, computers/servers, thehand-held device 113, the transport unit 110, etc. in the respectivehospitals and may function as a cloud-based platform accessible for manydifferent hospitals and other facilities. However, in other embodiments,the hygiene enhancing system may be set up for one facility only. Thecentral control unit 122 may also comprise databases for storinginformation and observations as well as data. Furthermore, the centralcontrol unit may comprise an analysis module 124 and report modules forpresenting the data from the database to relevant persons.

The hospital 121 consists of numerous rooms and areas which need to becleaned frequently. The hospital 121 may be divided into several zones,such as administrative areas 125, bed wards 126, examining wards 127,operating rooms 128, lavatories 129, etc., as shown schematically inFIG. 4. These zones need different types and levels of cleaning and alsomay require different levels of cleanliness. By the present hygieneenhancing system, the cleaning of each zone may be optimised andscheduled in relation to requirements. Furthermore, sensors 130, such aspassive infrared (PIR) sensors, may be arranged in each room section formonitoring and detecting movements of persons in the room or area. ThePIR sensors 130 may be connected with the central control system.

Furthermore, as seen in FIG. 4, it is easily deduced that the need forcleaning may be different from room to room. For instance, the bed ward126 does not need the same cleaning as the operating room 128 and thelavatory 129. In addition, a holistic system is provided for collectingkey data regarding the hygiene effort in e.g. hospitals, on e.g. abiologic level. Furthermore, an overview tool is provided for assistingthe management in enhancing the cleaning effort to minimize thespreading of infections.

Moreover, by giving the cleaning operatives direct access to hand-helddevices 113 which may be used to perform real-time measurements of thelevel of cleanliness, these measurements may be a daily indicator of thequality of the cleaning. The measurements may be collected in databasesso that the data can be analysed and compared to determine and validatethe hygiene level in the areas of the facility, e.g. the hospital.

Furthermore, by using sensors 130 placed around the rooms and areas forestablishing an activity load, i.e. “the human load which is exerted oncertain areas”, such as lavatories, offices, etc., the cleaning effortsmay be optimised so that areas with a high activity load may be cleanedmore frequently than areas with a lower activity load.

In FIG. 5, the hand-held device 113 is shown as a tablet. The tablet hasthe add-on module 117, and a sample 131 is being inserted into theadd-on module 117 for measuring the level of cleanliness as describedabove. The display 116 shows the user interface 132 enabling thecleaning operative to document the cleaning of the room/area. The datais communicated to the central control unit.

Accordingly, the hygiene enhancing system may be developed as an opensource, cloud-based, holistic IT platform which is able to support alllevels of e.g. the hospital organisation in review management, resourcemanagement and reporting tools, as schematically shown in FIG. 6.

The hand-held device 113 has a built-in positioning unit, which makesall interaction with the hygiene enhancing system locality-specific. Inthis way, it is always possible to tell where cleaning is being done,who is doing it, how they are doing it and how well.

All information relevant to the cleaning operatives is digitalised,including information on: procedures, guidelines, instructions, cleaningdetergents/articles/equipment, safety at work, etc., as seen in userinterface 133 in FIG. 6.

Thereby, the hygiene enhancing system is able to guide the individualcleaning operative through the cleaning procedure, e.g. in the lavatory129, as shown in FIG. 6. The hygiene enhancing system also collects andanalyses information on the working pattern, information enquiries andcleaning results of the individual operative and uses this as a basisfor proactively supporting the operative with his or her competencydevelopment—i.e. decodes where extra courses and support are required.

All information is distributed via “push”, which provides for a uniqueadvantage in connection with intelligent allocation of cleaningactivities, including how cleaning operative are to react in emergenciessuch as virus outbreaks etc.

As mentioned above, the hand-held device 113 collects and analysesreal-time hygiene measurements of e.g. ATP tests, visual inspections,fluorescent gels, microbiological tests, etc. in connection with allcleaning procedures, which results in the shortest feedback/responsetime possible. Particularly data collection and reporting of key dataare essential.

The hand-held device 113 gives the cleaning operative 115 instantfeedback on whether his or her cleaning meets the threshold level ofcleanliness.

The hand-held device 113 keeps track of all detergents, articles andequipment on the transport unit 110 and notifies the cleaning operativewhen replacements and filling up are necessary, and ensures that clothsetc. are changed regularly.

The massive data collection associated with the “load monitoring” of thedifferent areas of a facility, e.g. the hospital, will provide anopportunity to anticipate patient situations in terms of safety. Thisuse of artificial intelligence where data processing and simulation areused to predict the consequences of certain actions or lack thereof mayprove to be extremely useful for preventing spreads of infectiousdeceases through the indoor environment.

Key figure simulation allows the management to thoroughly test andstreamline scenarios so that impact analyses of e.g. increased (orreduced) cleaning activity can be checked without having to perform realphysical tests in the organisation.

Thus, by implementing the hygiene enhancing method and system accordingto the invention, the management and hygiene organisation may obtain thefollowing advantages on a strategic level:

Cost Management:

-   cost overview—price versus quality of cleaning service,-   key figure simulation

Quality Control and Quality Control Tool:

-   overall view of quality of cleaning,-   reporting tools

Hygiene Readiness:

-   overview of the total hygiene readiness of the organization,-   control parametres in case of virus breakouts,-   load rate (possible by connecting systems to ensure that the    “hygiene readiness” in hospital areas is monitored).

Furthermore, the hygiene organisation and service management may obtainthe following advantages on a tactical level:

Resource Overview and Management Tool:

-   overview of staff,-   planning and allocation of cleaning (including use of load    algorithms),-   mapping out hygiene levels and cleaning efforts,-   data collection and reporting to authorities etc.;

Quality Control and Quality Control Tool:

-   overview of quality of cleaning,-   overview of equipment;

Competency Development:

-   overview of employees and competencies,-   focused competency boost of the cleaning operatives of the    organization.

Moreover, the cleaning operatives, in-house employees and externaloperatives may obtain the following advantages on an operational level:

The hygiene enhancing system digitises information directed at cleaningoperatives to make it easier for the operatives to access relevantknowledge as required;

The hygiene enhancing system guides the cleaning operative throughcleaning each room based on load rate and recommendations for thespecific type of room;

Cleaning is quality-assured by:

-   not allowing the cleaning operative to move on to the next room    until high-risk points have been cleaned at an level of cleanliness    below the predetermined threshold of high-risk points in the    specific room;-   several types of controls are performed to ensure that the hygiene    enhancing system is used correctly;-   automatically generated statistics of the cleaning (these statistics    are used for analysing the need for cleaning and optimum use of the    cleaning staff.)

FIG. 7 shows a lavatory 1, e.g. from the hospital, seen from an oppositeend of the door 3. Inside the lavatory 1, different toilet componentsare arranged. In this embodiment, the lavatory 1 comprises a toilet 4having a first sensor 5, a soap dispenser 6 having a second sensor 7 anda sink 8 having a water tap 9, the water tap 9 having a third sensor 10.The lavatory 1 further comprises a paper dispenser 11 having a fourthsensor 12 and a disinfectant dispenser 13 having a fifth sensor 14.Furthermore, the disinfectant dispenser 13 is connected with the closingmechanism of the door 3 so that when a disinfectant has been dispensedfrom the disinfectant dispenser 13, the door 3 will open. Furthermore, apassive infrared (PIR) sensor 40 is arranged in the lavatory 1. In thisembodiment, the PIR sensor 40 is arranged in a ceiling 41 of thelavatory. The PIR sensor 40 is adapted to detect movement of persons inthe lavatory.

Furthermore, a second PIR sensor 42 is arranged in the lavatory and isdirected towards the toilet and a zone around the toilet 4, the secondPIR sensor 42 being adapted to detect movements of a person around thetoilet 4 in the zone. In FIG. 2, the lavatory 1 of FIG. 1 is shown inanother view.

The basic idea of the hygiene behaviour support system 2 as describedabove in connection with FIGS. 7 and 8, and which may be an additionalassisting system for improving the overall hygiene, is that users, bymeans of indicators, such as light, touch-free components and verysimple written communication, is easily guided to good hand hygiene inconnection with going to the lavatory. Further, the users will havetheir hands disinfected with a disinfectant, such as alcohol-based handrub, before leaving the toilet lavatory 1, since the disinfectantdispenser 13 serves as a door opener.

Biological and microbiological measurements have shown that thesurroundings in the lavatories 1 are contaminated and constitute apotential danger of contamination to the users. The hygiene behavioursupport system makes it possible to use the lavatory without having totouch anything on the way in, during the visit and on the way out,presumably reducing the risk of infection.

Furthermore, the hygiene behaviour support system 2 is adapted tocollect real-time measurements of the users' hygiene-related behaviouralpatterns when being in the lavatory. The hygiene behaviour supportsystem also comprises a control unit connected with the sensors. Thedata collected from the sensors are processed in a storage device, adatabase, and subsequently compared inter alia to a number of developedscenarios of user behaviour. On this basis, the hygiene behavioursupport system is capable of continuously defining the hygiene behaviourof each individual toilet visit, however always in anonymous form.

Also, the hygiene behaviour support system is adapted to collectingvital data from the various units of the system (soap dispenser, paperdispenser, disinfectant dispenser, water tap and toilet flush sensor).The collection of real-time data allows for the uptime of the hygienebehaviour support system—as compared to the uptime of non-monitoredsystems—to be considerably increased because the people responsible forthe system are capable of monitoring and servicing the units before theyrun out of consumables and/or battery. Further, the maintenance of thesystem may—if desired—be placed with an external operator, and theservicing of the system may be planned in detail because of the closemonitoring and data registration.

All of the above data collected on the storage device, server database,may be presented in display applications, hand-held devices (tabletsetc.) as well as on smartphones etc.

In connection with the data collection and intervention of the hygienebehaviour support system, SMS notifications or similar short messagesmay—in the long run—be sent to relevant persons notifying them ofdesired intervention, e.g. “There is no more spirits-based handdisinfectant of type X in dispenser Y in toilet Z” or “The ideal levelof clean toilet visits in toilet X has been exceeded by Y%.

The hygiene behaviour support system is based on a motivation mind-setand aims at involving the users in the maintenance of a correct hygienestandard and hence increasing their own health-related safety.

The display application developed is capable of displaying historicaldata about the hygiene behaviour exercised in the lavatories. Asrequired, the various graphs presents data hour by hour, day by day,month by month or the like and compares these data with e.g. the samedata set from the day, month or year before. In this way, the user isinvolved directly and urged to “compete” with himself/herself inimproving the hygiene level. The hospital may adopt desired levels asreference lines or the like, so everyone can see the desired level. Ithas never previously been possible to monitor the frequency of handhygiene in real-time, and consequently it has never been possible todetermine desired requirements in this respect. It is epoch-making thatit is now possible to discuss the level of hand hygiene and then allowfor qualified interventions in order to increase the focus on this area.

Display applications may also be used to show all types ofhygiene-related information and guidance from hospital staff and staffresponsible for hygiene.

In the case of alarming conditions such as the outbreak of E. Coli orClostridium Difficile, new guidelines for desired hygiene behaviour maybe communicated via displays, and it may be measured directly whetherthe users embraces the new, strict guidelines. In other words, thehygiene behaviour support system may form part of the crisis responseand support the management by the staff of critical situations.

The hygiene behaviour support system 2 makes it possible for a user tobe able to “close” the lavatory for further visits, until the lavatoryhas been cleaned, if the user believes that the lavatory has beencontaminated. The user has this opportunity both if the user finds thelavatory contaminated when entering the lavatory, and if the user—due tohis health/condition—contaminates the lavatory himself (vomit, faeces orthe like).

The server/database of the hygiene behaviour support system is preparedto be able to retrieve and process key data concerning the degree ofcleanliness of the toilet by means of microbiological and biologicalmeasurements, etc.

As every lavatory is uniquely registered in the database, key data maybe collected concerning other factors than hygiene behaviour and stateof the units.

As mentioned above, a hygiene enhancing method has been developed fordefining the degree of cleanliness by means of systematic processcontrol, which allows for the determination and control of a desiredlevel of cleanliness.

The biological measurements have been used to define the degree ofcleanliness, and these measurements have been performed by means ofhand-held so-called ATP meters. Since these meters may send their datato a mac/PC via docking stations, it is possible to collect measurementsof degrees of cleanliness before and after cleaning and process thesedata on the server of the hygiene behaviour support system.

A solution has been developed in which these data may be transferredwirelessly, and then an ecosystem may be established with hygienebehaviour and an ideal degree of cleanliness in the lavatory or otherrooms and areas of a facility.

If either alarming hygiene behaviour and/or degrees of cleanliness aredetected (these numbers may in the long term be compared and possiblyanticipate alarming situations), the lavatory can be closed down andcleaning performed.

FIG. 9 shows a schematic view of the hygiene behaviour support system 2,as described in connection with FIGS. 7 and 8, which may function aspart of the overall hygiene enhancing system. The core of the hygienebehaviour support system 2 is the control unit 30, e.g a Netduino opensource electronic platform based in a 32-bit microcontroller.

The Netduino 30 is a down-system connected with the toilet components,e.g. the sensors 5, 7, 10, 12, 14, 40 in an embodiment via a centralwireless transceiver 31, and then via a number of local, wirelesstransceivers 31 and PIC circuits 32 which are all installed directly inthe soap, disinfectant and paper dispensers as well as by the water tapand the toilet flush sensor

Furthermore, the soap, disinfectant and paper dispensers are allprovided with newly developed LED light sources, i.e. indicators,which—by means of pulsating light in a certain order—guide the users toperforming good hand hygiene. Current is supplied to the localtransceivers 31, PIC circuits 32 and guidance directly from thedispensers' own battery supply, and the extra current power consumptiondoes not change the otherwise normal lifetime of the batteries.

The Netduino 30 is up-system connected via a wireless 3G modem 33(connection may also be made via an existing Ethernet connection) toe.g. a Windows Azure database solution 34, i.e. the storage unit, whichis a heavy open source cloud-platform. The programming language is basedon .Net and is handled via NHibernate module 35. The code is in thecloud, which allows for system maintenance and development to beperformed decentrally. In another embodiment, the code is present on theNetduino 30 so the overall security of the system is enhanced. However,system maintenance and development are to be performed locally.

Real-time key data from the hygiene behaviour support system 2 may bepresented directly in a—especially for the system—browser-developeddisplay-user interface. Hence, data from the system may be delivered toa locally installed display 36 in a patient ward, on which to displayinformation about the current hand hygiene. Information thus flows tothe service provider responsible for ensuring that consumables (soap,hand disinfectant, paper and batteries etc.) and to e.g. the hygieneunits in the hospital being responsible for hygiene together with theheads of the various wards.

As all data about the state of consumables (paper, soap and handdisinfectant consumption) as well as the battery level of all the unitsare collected continuously, it is possible to prevent entirely that theunits run out of battery/power or go out of operation. All data from thesystem may be passed on directly via an SMS service to the personsresponsible for the cleaning of the lavatories and e.g. to the hygienenurse in the event that the hand hygiene drops below the desired level

Furthermore, biological and/or microbiological measurements may be usedto define the degree of cleanliness, and these measurements have beenperformed by means of hand-held so-called ATP meters 37.

By the hygiene enhancing system it is obtained that the personresponsible for hygiene may determine a hygiene level through continuouscleaning and behaviour measurements, and with this knowledge at handenhance, maintain and quality-assure the hygiene efforts in the entirefacility or building.

Furthermore, it is possible for the cleaning operatives to carry outtheir assignments with a high degree of professionalism, and the hygieneefforts may be continuously documented in real-time and adjusted bymeans of the hand-held devices available to the cleaning operativeson-site.

The hand-held devices provides relevant information regarding position,cleaning procedures and guidelines, cleaning detergents, cleaningarticles and equipment to the cleaning operatives for the specific areahe or she is cleaning.

Furthermore, the hand-held device is adapted to be a tool assisting thecleaning operatives in navigating the huge amount of data andinstructions/procedures so that their main concern—the cleaning—canalways be done as professionally and efficiently as possible. Inaddition, the hand-held device may be adapted to collect key cleaningdata and assist the cleaning operative in meeting the quality demands.

Thus, by applying the activity load measurements and systematic analysisof the real-time measurements of the level of cleanliness, it ispossible to define the cleaning effort as intelligent and thereby createa quality scale for the hygiene effort.

Accordingly, the hygiene enhancing method and system provide theorganisational levels (strategic, tactical, and operational) of thefacility, e.g. the hospital, with a holistic overview and possibilitiesregarding the cleaning effort and the quality of same, and not least newpossibilities of supporting the cleaning operatives in carrying outtheir assignments in the most effective and correct manner.

The hospitals and facilities thus have the opportunity to streamlinetheir cleaning activities, not only on time spent, but also moreimportantly with focus on the quality of cleaning.

The hygiene organisation of the hospital or facility will be providedwith the hygiene enhancing system, whereby corrective measures may betaken in situ, i.e. where the cleaning is performed and in real-time.

With the hygiene enhancing method and system according to the presentinvention, the cleaning operatives control and guide themselves eachtime they clean a room or area. In addition, the cleaning operativeswill be provided with the necessary technologic assistance in the formof the hand-held device which provides procedures and guideline supportduring the cleaning as well as continuous reporting and a possibility tosearch for relevant information.

As mentioned above, the hand-held device has a positioning unit so thatthe position of the hand-held device is available at all time, andthereby, it is also obtained that the cleaning operative may be guidedthrough how cleaning should be performed in that given area, both innormal circumstances and in circumstances where an outbreak for virus isdiscovered, in which circumstance all cleaning procedures will betightened, and where the need for following the new cleaning procedureshas to be communicated to the cleaning operatives immediately tominimise the spread of the infection.

Although the invention has been described in the above in connectionwith preferred embodiments of the invention, it will be evident for aperson skilled in the art that several modifications are conceivablewithout departing from the invention as defined by the following claims.

1-36. (canceled)
 37. A hygiene enhancing method for enhancing a hygienein a room or area of a facility, the method comprising the steps of:cleaning the room or area, extracting one or more samples frompredetermined surfaces in the room or area, performing real-timemeasurements of a biological and/or microbiological level of cleanlinessof the one or more samples by means of a on-site hand-held device,comparing the measured level of cleanliness of the one or more sampleswith a predetermined biological and/or microbiological threshold foracceptable hygiene, determining if the measured level of cleanliness islower than the predetermined threshold, cleaning the room or zones ofthe room having a lower level of cleanliness than the predeterminedthreshold, extracting one or more samples from the predeterminedsurfaces in the room or area having the lower level of cleanliness thanthe predetermined threshold, performing real-time measurements of thelevel of cleanliness of the one or more samples extracted from thepredetermined surfaces in the room or area having the lower level ofcleanliness than the predetermined threshold by means of the on-sitehand-held device, comparing the predetermined threshold with themeasured level of cleanliness of the one or more samples from thepredetermined surfaces in the room or area having the lower level ofcleanliness than the predetermined threshold, determining if themeasured level of cleanliness is lower than the predetermined threshold,and continuing the steps of cleaning, extracting samples, measuringsamples, comparing and determining until the real-time measured level ofcleanliness for all predetermined surfaces is below the predeterminedthreshold.
 38. A hygiene enhancing method according to claim 37, furthercomprising the step of communicating the level of cleanliness measuredin real-time to a central control unit in order to collect data of thehygiene of the room or area being cleaned and/or of a cleaning operativecleaning the room or area to be used for enhancing the competences ofthe cleaning operative.
 39. A hygiene enhancing method according toclaim 37, further comprising the steps of: providing a position of thehand-held device by means of a positioning unit in the hand-held device,and communicating the real-time position of the hand-held device to thecentral control unit.
 40. A hygiene enhancing method according to claim37, further comprising the steps of: monitoring an activity load of theroom or area by means of sensors arranged in the room or area, andcommunicating the activity load to the central control unit.
 41. Ahygiene enhancing method according to claim 40, further comprising thestep of communicating to the hand-held device when the hand-held deviceenters a room or area having a high activity load to warn the cleaningoperatives cleaning the room or area that additional cleaning of theroom or area may be needed in order for the level of cleanlinessmeasured in real-time to be lower than the predetermined threshold. 42.A hygiene enhancing method according to claim 37, wherein the step ofcomparing is performed automatically by the hand-held device.
 43. Ahygiene enhancing method according to claim 37, further comprising thestep of communicating additional and/or strict cleaning procedures andguidelines to the hand-held device when the hand-held device enters aroom or area having special cleaning needs, such as an outbreak of E.Coli or Clostridium Difficile.
 44. A hygiene enhancing method accordingto claim 37, further comprising the step of providing cleaningprocedures and guidelines on a display of the hand-held device to givethe cleaning operative cleaning the room or area real-time access to theprocedures and guidelines.
 45. A hygiene enhancing system for carryingout the hygiene enhancing method according to claim 37, the hygieneenhancing system comprising: a transport unit with cleaning detergentsand cleaning articles to be used for cleaning a room or area of thefacility, a plurality of testing items for extracting one or moresamples from predetermined surfaces, and an on-site hand-held device forperforming real-time measurements of a biological and/or microbiologicallevel of cleanliness of the one or more samples.
 46. A hygiene enhancingsystem according to claim 45, wherein the hand-held device comprises acommunication unit adapted to send and receive information.
 47. Ahygiene enhancing system according to claim 45, wherein the hand-helddevice is a smartphone or a tablet.
 48. A hygiene enhancing systemaccording to claim 47, wherein an add-on module is connected to thehand-held device, the add-on module being adapted to measure the levelof cleanliness of the one or more samples.
 49. A hygiene enhancingsystem according to claim 46, wherein the hand-held device comprises acamera and a processor, the camera and processor being adapted tofunction as a biosensor for detecting the biological and/ormicrobiological level of cleanliness of the samples.
 50. A hygieneenhancing system according to claim 46, further comprising a centralcontrol unit connected with the hand-held device and/or the transportunit.
 51. A hygiene enhancing system according to claim 50, wherein thelevel of cleanliness measured in real-time is communicated to thecentral control unit in order to collect data of the hygiene of the roomor area being cleaned and/or of a cleaning operative cleaning the roomor area to be used for enhancing competences of the cleaning operative.52. A hygiene enhancing system according to claim 50, wherein thehand-held device comprises a positioning unit, and the positioning unitcommunicates the real-time position of the hand-held device to thecentral control unit and/or the transport unit comprises a positioningunit.
 53. A hygiene enhancing system according to claim 45, wherein oneor more sensors are arranged in the room or area to monitor the activityload of the room or area and/or the consumption of soap dispensers,paper dispensers or disinfectant dispensers arranged in the room orarea.
 54. A hygiene enhancing system according to claim 50, wherein thecentral control unit comprises a storage unit for storing data andobservations received from the hand-held device, the transport unitand/or the sensors.
 55. A hygiene enhancing system according to claim50, wherein the control unit sends a message to the hand-held devicewhen the hand-held device enters a room or area having a high activityload in order to warn the cleaning operatives cleaning the room or areathat additional cleaning of the room or area may be needed in order forthe level of cleanliness measured in real-time to be lower than thepredetermined threshold.
 56. A hygiene enhancing system according toclaim 50, wherein the central control unit communicates additionalcleaning procedures to the hand-held device when the hand-held deviceenters a room or area having special cleaning needs, such as an outbreakof E. Coli or Clostridium Difficile.
 57. A hygiene enhancing systemaccording to claim 50, wherein the hand-held device comprises cleaningprocedures and guidelines accessible for the cleaning operative cleaningthe room or area.